Nikoran Iv-2

NIKORAN IV-2 Injection

NIKORAN IV-2 Injection, manufactured by Torrent Pharmaceuticals Ltd., is a medication primarily used for the management and prevention of heart-related chest pain, known as angina. This medicine is administered intravenously and contains Nicorandil as its active ingredient.

• Name:
  • Brand Name: NIKORAN IV-2, Nikoran 2 mg Infusion/Injection
  • Common Name: Nicorandil Injection
• Composition:
  • The active ingredient is Nicorandil (2 mg per vial/ml).
• Uses:
  • NIKORAN IV-2 is prescribed for the symptomatic treatment of angina pectoris (chest pain).
  • It is used in patients who have not responded adequately to or cannot tolerate first-line antianginal medications, such as beta-blockers and/or calcium antagonists.
  • It works by relaxing and widening the heart's blood vessels, which improves blood flow and oxygen supply to the heart muscle, thereby reducing the workload on the heart and relieving pain.
• Dosage and Administration:
  • This medicine is typically administered in a clinical or hospital setting under the supervision of a qualified healthcare professional.
  • Self-administration is not advised.
  • The dose and rate of infusion are determined by the doctor based on the patient's condition and response to treatment.
  • Treatment may continue for 24 to 48 hours, often followed by a transition to oral Nicorandil as directed by the doctor.
• Side Effects:
  • Common Side Effects: Headache, flushing (warmth and redness of skin), dizziness, weakness, nausea, vomiting, palpitations (irregular heartbeat), pain at the injection site, and fatigue.
  • Serious Side Effects: Severe allergic reaction, yellowing of skin and eyes, increased potassium levels, gastric or duodenal ulcers, mouth ulcers, and severe hypotension (low blood pressure).
• Precautions:
  • Patients should inform their doctor if they have low blood pressure, severe kidney or liver impairment, or a history of gastrointestinal diseases or ulcers.
  • It is not recommended for use with phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil) due to an increased risk of severe low blood pressure.
  • Caution is advised with corticosteroids and tricyclic antidepressants due to potential interactions.
  • Alcohol consumption should be avoided as it can intensify the blood pressure-lowering effect and cause dizziness.
  • Use during pregnancy and breastfeeding should be discussed with a doctor.
  • Activities requiring high mental alertness, such as driving or operating machinery, should be avoided during or immediately after treatment due to potential drowsiness and dizziness.
• Storage:
  • Store Nikoran IV-2 Injection in a refrigerator, between 2-8°C.
  • Do not freeze the medicine.
  • After opening, any unused portion should be discarded immediately.
  • Keep out of reach of children.

What is NIKORAN IV-2 used for?

NIKORAN IV-2, containing the active ingredient nicorandil, is used in the management of unstable angina, a severe type of chest pain that occurs when the heart muscle doesn't get enough blood. It is also used to prevent slow coronary flow phenomena in patients undergoing percutaneous coronary intervention (PCI).

How does NIKORAN IV-2 work?

NIKORAN IV-2 works through a dual mechanism. It is a potassium channel opener and a nitric oxide (NO) donor. As a potassium channel opener, it relaxes the smooth muscle cells in blood vessels, widening them and reducing the heart's workload. As an NO donor, it further relaxes blood vessels, particularly veins, decreasing the amount of blood returning to the heart. This combined action increases blood and oxygen supply to the heart muscle while reducing its oxygen demand, thereby alleviating chest pain.

What is the usual dosage and administration for NIKORAN IV-2?

NIKORAN IV-2 is for intravenous infusion only. The usual starting dose for intravenous drip infusion is 2 mg per hour, and it should not exceed 6 mg per hour. The contents of the NIKORAN IV vial should be dissolved in physiological saline or 5% glucose solution for injection and must be used within 24 hours of preparation. It should not be administered simultaneously through the same line with other intravenous solutions.

What are the possible side effects of NIKORAN IV-2?

Common side effects include headache, nausea, vomiting, dizziness, weakness, flushing (reddening of the skin), and a decrease in blood pressure or an increase in heart rate. More serious but less common side effects can include ulcers (in the mouth, stomach, intestines, skin, or eyes) and severe hypotension.

Is NIKORAN IV-2 safe during pregnancy or breastfeeding?

NIKORAN IV-2 is generally not recommended during pregnancy or breastfeeding. There is limited information on its safety in pregnant women, and animal studies have shown potential harmful effects at high doses. It is unknown if nicorandil passes into breast milk or its effects on a nursing infant, so its use is usually avoided.

Can NIKORAN IV-2 be taken with other medications?

NIKORAN IV-2 should not be taken with phosphodiesterase 5 (PDE-5) inhibitors (e.g., sildenafil, tadalafil, vardenafil) or soluble guanylate cyclase stimulators (e.g., riociguat) due to the risk of a severe and dangerous drop in blood pressure. Caution is advised when taking it with other vasodilators, tricyclic antidepressants, or alcohol, as these can increase its blood pressure-lowering effect. Non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen may increase the risk of gastrointestinal ulcers when taken with nicorandil.

What precautions should be taken when receiving NIKORAN IV-2?

Your blood pressure and hemodynamics will be monitored frequently during administration, and the dosage will be adjusted based on your response. It should be used with caution in patients with low blood pressure, serious liver or kidney problems, heart failure, low blood volume, or pulmonary edema. It is contraindicated in conditions such as cardiogenic shock. You should inform your doctor if you experience dizziness or weakness, as these can impair your ability to drive or operate machinery.

How should NIKORAN IV-2 be stored after preparation?

Once the NIKORAN IV-2 injection vial contents are dissolved in physiological saline or 5% glucose solution, the prepared solution must be used within 24 hours. The original, unopened vials should be stored as per the manufacturer's instructions, typically protected from moisture and heat.